12840 SW 107TH COURT 12840 SW 107TH COURT ---
I
1
4-1
it
7
O
U
L
4J
O
�-1
•
3
tJ')
O
d
m
N
City Of T ; ga and y`�
INSPECTION RECU EST'
for � 3� ,
F1 IU44
INSPECTION TIME:------ ?E RM,T N�.
DATE: Of ll;�f ATE ;SSUED:_.-j
D))VNERS NAME: r 'Z.
ADDRESS :/�
RA^wTUR :
TEST' 4 LCA , 'Niter � , �is�g1 , �a�a�al�•Y
�E3i;LT. :,Q�,;-Y�d ..�.�-•wed "
3'1ET"C40N:
f
4;,�'JPE y70R DATE
LNOTE: Waah s'aap,eTantvl •* • d • ne•e•]
i .of Tigard
INSPECTION RECUEST
for
Z/5 .INSPECTION TIME : PFR41 i
DATE: 9 19i';'s' SA'''E SSJED:_...�
OWNERS NAME : !Scru(P`r
TEST: Air �, , , '-tor r- , 'ji lug, r , La 5 ora to-y
RE3ULT: Apar:vad :.`3-.p roved
S;<ETCH:
�A SPE"'.71'OR DATE
rNO?E: A1lacn viap;emental !go! dato here,I)
k�
9
4
o
/14
Y
V
t
�J
Q ^
O W
2w
(7 w 4c , o_
CL p16)
^� U •
n
a o
Cc
h-
W ►- a 2 M d• 3 n
z .1 W 0 a
cn 0 Z O V a v
L) Q a J =
V 49
d 2 Z N y
(n 3t O W WY o
? o 0 �" N , U
w w w w l w R w
lY Tigard
of Ti and
INSPECTION REQUEST
.f o r
IN �
SPECTION TIME. PERMIT NO. :--.. `
D��i E: DATE ISSUED
OWNERS 1,4'AME : _ I
ADDRESS:4,01 � j�___ ttt �-vim I
CONTRACTOR : _
TEST : Air f], Wo er , VieoolO
, Laboratory p
RESULT: Approve ❑ Diserp►oved Cl Pending U
SKETCH;
I
IN OR DATE
LOTE: Attach aupr'emental 449f data beret]
4PM'",;a,' yM1RP7yiM�:.,...,.-r«n�sw.... .r.._.-t.Qr....,.,�. ,:*M.a.+T'S1�N1111*1111111111110 rn.,.w.,.q..igRRdp•Rt�IMp„ pry/'1p.�.ylRi��M1VFw11pA'Faw -.: ^,.C,.....-...-.
CITY OF
BUILDING PERMIT APPLICATION TIGARD DATE x`24 7�� N° 0 ,357
1HE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED
OR AS SHOWN AND APPROVED IN THE. ACCOMPANYING PLANS AND SPECIFICATIONS. OWNERPHONE
OWNER I- fa x p i"s� �dy ADDRESS .'w• E ltrFl 1.1.e BUILDER PHONE
ENGINEEP
flU1LCER 4YW11BP ARCHITECT_ DESIGNER
STRUCTURE ®NEW :J REhIODEL (—]ADDITION ❑REPAIR ❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION
❑ RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑r'AR PORT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE
❑BOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY LAND USE ZONE '°7 BLDG.TYPE_ FIRE ZONE PLAN CHECK BY rra HEAT
r.-inbtruct split entry dwelling according to approved plans
137: sqe ft. frame ittachad ganags
Q CLOAD FLOOR LOAD 40 1b HEIGHT NO.STORIES 1 AREA 2744 VALUE 31 11,500
BUILDING DEPARTMENT cET BACKS FRONT REAR AJ LEFT SIDE 16-6 RIGHT SIDE 6-6
Permit
—' THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check 3M Ir . REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS ACID IN COMPLIANCE WITH
Recording ALL APPLICABLE CODES AND ORDINANCES, THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
1%State ,1 eWl LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total
BY et
APPLICANT OR AGENT
Approved rfa Receipt No.
ADDRESS F 1,)Nt'
DATE INSP. TYP" INSPECTION REMARKS PLUMBING DA1,
Permit No.
Rough-in
/Y7 Fixture
/get,.
It Final
Jl'l T,)6 LJ -2 c HEATING
-Contractor E J. A's
Permit No8
e 1.e" . .2G3S Or Oil
Rough in
Final
SEWER Q 7 ,1 7-
Final
DRIVEWAY 14,0#IV 0 W/o z
Final
Storm Drainage
(Rain Drain) Final
Sidewalk Coo k 75
Curb&Street Final
ARpLqach Coo/( 9-ef-7,5-
BLDG. DEPT, FINAL TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Final
Landscaping
Zoning Fin.11
i
I
ti
ADDRESS b pl c% = j�_•� 1 C 7 c c_ PERMIT N0. /3 l
PERMIT CHARGE none
OWNER CONNECTION FEE
J
PAID BY , %_:. tk
TYPE OF BUILDING ��,`,,re DATE CONNECTED
SERVICE RATE I,�� r+,�_�_.L�,___ __ _ _ , INSPECTION FEE17
5�
4
CONTRACTOR 1 c _ PAID BY DATE
SIZE OF CONNECTI O _�_ ASSESSMENT PAID
I
r J ,
r'j
1
� ,� ��
i
� 4 u ���k ;,,,.��E��
���,i v� �, � �a
^d i y�`Jr���l►'1
�.� I
�� �
—__._..�4,.__.1—� � ____��___.
�J